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Intelligent ePR system for evidence-based research in radiotherapy: proton therapy for prostate cancer

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Proton therapy (PT) utilizes high energy particle proton beam to kill cancer cells at the target region for target cancer therapy. Due to the physical properties of the proton beam, PT delivers dose with higher precision and no exit dose compared to conventional radiotherapy. In PT, patient data are distributed among multiple systems, a hindrance to research on efficacy and effectiveness. A data mining method and a treatment plan navigator utilizing the infrastructure and data repository of a PT electronic patient record (ePR) was developed to minimize radiation toxicity and improve outcomes in prostate cancer treatment.

Materials/method(s)

The workflow of a proton therapy treatment in a radiation oncology department was reviewed, and a clinical data model and data flow were designed. A prototype PT ePR system with DICOM compliance was developed to manage prostate cancer patient images, treatment plans, and related clinical data. The ePR system consists of four main components: (1) Data Gateway; (2) ePR Server; (3) Decision Support Tools; and (4) Visualization and Display Tools. Decision support and visualization tools are currently developed based on DICOM images, DICOM-RT and DICOM-RT-ION objects data from prostate cancer patients treated with hypofractionation protocol proton therapy were used for evaluating ePR system effectiveness. Each patient data set includes a set of computed tomography (CT) DICOM images and four DICOM-RT and RT-ION objects. In addition, clinical outcomes data collected from PT cases were included to establish a knowledge base for outcomes analysis.

Results

A data mining search engine and an intelligent treatment plan navigator (ITPN) were developed and integrated with the ePR system. Evaluation was based on a data set of 39 PT patients and a hypothetical patient.

Conclusions

The ePR system was able to facilitate the proton therapy workflow. The PT ePR system was feasible for prostate cancer patient treated with hypofractionation protocol in proton therapy. This ePR system improves efficiency in data collection and integration to facilitate outcomes analysis.

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Abbreviations

AJCC:

American Joint Committee on Cancer

CSS:

Cascade Stylesheet

CT:

Computed Tomography

CTCAE:

Common Terminology Criteria for Adverse Events v3.0

CTEP:

Cancer Radiation Therapy Program

DB:

Database

DICOM:

Digital Imaging and Communications in Medicine

DRR:

Digital Reconstructed Radiograph

DVH:

Dose Volume Histogram

ePR:

Electronic Patient Record

GUI:

Graphical User Interface

HIPAA:

Health Insurance Portability and Accountability Act

IPILab:

Image Processing and Informatics Laboratory

IRB:

Institutional Review Board

ITPN:

Intelligent Treatment Planning Navigator

KB:

Knowledge Base

LLUMC:

Loma Linda University Medical Center

NCI:

National Cancer Institute

NAPT:

National Association for Proton Therapy

OAR:

Organ at Risk

PACS:

Picture Archiving and Communication System

PSA:

Prostate-Specific Antigen

PT:

Proton Therapy

QA:

Quality Assurance

SOBP:

Spread Out Bragg Peak

ROI:

Region of Interest

RT:

Radiation Therapy/Radiotherapy

TP:

Treatment Plan

TPS:

Treatment Planning System

USC:

University of Southern California

WS:

Workstation

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Authors and Affiliations

  1. IPILab, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA

    Anh H. Le, Brent Liu & H. K. Huang

  2. Department of Radiation Oncology, University of Florida, PO Box 100385, Gainesville, FL, 32608, USA

    Anh H. Le

  3. James M. Slater, MD Proton Treatment and Research Center, Department of Radiation Medicine, Loma Linda University, Loma Linda, CA, USA

    Reinhard Schulte

Authors
  1. Anh H. Le
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  2. Brent Liu
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  3. Reinhard Schulte
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  4. H. K. Huang
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Corresponding author

Correspondence to Anh H. Le.

Additional information

Excerpted from Le, A. (2010). Mining an ePR system using a treatment plan navigator for radiation toxicity to evaluate proton therapy treatment protocol for prostate cancer, Doctoral Dissertation, University of Southern California, Los Angeles, California, US. Portions of the materials were presented at the the 24th International Congress and Exhibition of CARS, University Medical Center, Geneva, Switzerland, June 23–26, 2010.

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Le, A.H., Liu, B., Schulte, R. et al. Intelligent ePR system for evidence-based research in radiotherapy: proton therapy for prostate cancer. Int J CARS 6, 769–784 (2011). https://doi.org/10.1007/s11548-011-0551-y

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  • DOI: https://doi.org/10.1007/s11548-011-0551-y

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